<div style='padding-bottom: 1cm'>
	{include file="print_patient/element_print_header.html"}
</div>
<div style="width: 17cm; font-size: 14px;">
<table>
    <tr >
        <td align="center" style="padding-left: 4cm;padding-right: 4cm;">
        	<span class="printHeader" style="font: bold;">{translate}Report on patient died outside hospital{/translate}</span>
        </td>
    </tr>
</table>

<table width="100%" cellspacing="5px">
    <tr>
        <td colspan="4"><span style="font-weight: bold; text-transform: uppercase;">A. {translate}Patient{/translate}</span></td>
    </tr>
    <tr style="border-bottom: 1px dotted #000;">
        <td style="width: 1.4cm;">{translate}Full name{/translate}:</td>
        <td style="border-bottom: 1px dotted #000; width: 7cm;">{$patient->getName()}</td>
        <td style="width: 2.8cm;">{translate}Birthday{/translate}-{translate}Age{/translate}:</td>
        <td style="border-bottom: 1px dotted #000;">{$patient->getLocalizedDate('date_of_birth')} - {translate p1=$patient->getAge()}Age: %s{/translate}</td>
    </tr>
</table>
<table width="100%">
    <tr>
        <td style="width: 2.3cm;">{translate}Career{/translate}:</td>
        <td style="border-bottom: 1px dotted #000;">{$patient->getCareerName()}</td>
    </tr>
</table>
<table width="100%">
    <tr>
        <td style="width: 1.4cm;">{translate}Address{/translate}:</td>
        <td style="border-bottom: 1px dotted #000;">{$patient->getAddress()}</td>
    </tr>
</table>
<table width="100%">
    <tr>
        <td style="width: 3.9cm;">{translate}Company/parents information{/translate}:</td>
        <td style="border-bottom: 1px dotted #000;">{$deathInfo->get('relative_contacts')}</td>
    </tr>
</table>
<table width="100%">
    <tr>
        <td colspan="2"><span style="font-weight: bold; text-transform: uppercase;">B. {translate}Check-in{/translate}</span>
    </tr>
    <tr>
        <td style="width: 2.6cm;">{translate}Check-in time{/translate}:</td>
        <td style="border-bottom: 1px dotted #000;">{translate p1=$deathInfo->getCheckInTime('hh') p2=$deathInfo->getCheckInTime('mm') p3=$deathInfo->getCheckInDate()}%s oclock %s minute, date %s{/translate}</td>
    </tr>
</table>
<table width="100%">
    <tr>
        <td style="width: 3.7cm;">{translate}Injury description{/translate}:</td>
        <td style="border-bottom: 1px dotted #000;">
            <span>{translate}Pulse{/translate}:&nbsp;&nbsp;{$deathInfo->getPulse()} {translate}times/minute{/translate},&nbsp;</span>
            <span>{translate}Respiratory rate{/translate}: &nbsp;&nbsp;{$deathInfo->getRespiratory()} {translate}times/minute{/translate},&nbsp;</span>
        </td>
    </tr>
    <tr>
        <td>&nbsp;</td>
        <td style="border-bottom: 1px dotted #000;">
            <span>{translate}Pupillirary dimension{/translate}:&nbsp;&nbsp;{$deathInfo->getPupillaryDimension()}&nbsp;mm,&nbsp;</span>
            <span>{translate}Light reflection{/translate}:&nbsp;&nbsp;{$deathInfo->getLightReflection()}.</span>
        </td>
    </tr>
    <tr>
        <td>&nbsp;</td>
        <td style="border-bottom: 1px dotted #000;">
        	<span>{translate}Others{/translate}:&nbsp;&nbsp;</span>
            <span>{$deathInfo->getOtherDescription()}.
        </td>
    </tr>
    <tr>
        <td>&nbsp;</td>
        <td style="border-bottom: 1px dotted #000;">&nbsp;</td>
    </tr>
</table>    
<table width="100%">
    <tr>
        <td style="width: 4cm;">{translate}Emergency's action{/translate}:</td>
        <td style="border-bottom: 1px dotted #000;">{$deathInfo->get('medication_process')}</td>
    </tr>
     <tr>
        <td>&nbsp;</td>
        <td style="border-bottom: 1px dotted #000;" colspan="2">&nbsp;</td>
    </tr>
    <tr>
        <td>&nbsp;</td>
        <td style="border-bottom: 1px dotted #000;" colspan="2">&nbsp;</td>
    </tr>
</table>
<table width="100%">  
    <tr>
        <td style="width: 5.1cm;">{translate}Diagnosis of death cause{/translate}:</td>
        <td style="border-bottom: 1px dotted #000;">{$deathInfo->getDeathCaution()}</td>
    </tr>
     <tr>
        <td>&nbsp;</td>
        <td style="border-bottom: 1px dotted #000;" colspan="2">&nbsp;</td>
    </tr>
    <tr>
        <td>&nbsp;</td>
        <td style="border-bottom: 1px dotted #000;" colspan="2">&nbsp;</td>
    </tr>
</table>    
<table width="100%">
    <tr>
        <td style="width: 1.7cm;">{translate}Conclusion{/translate}:</td>
        <td style="border-bottom: 1px dotted #000;">{$deathInfo->getConclusion()}</td>
    </tr>
    <tr>
        <td>&nbsp;</td>
        <td style="border-bottom: 1px dotted #000;" colspan="2">&nbsp;</td>
    </tr>
</table>
<table width="100%">   
    <tr>
        <td colspan="2"><span style="font-weight: bold; text-transform: uppercase;">C. {translate}Emergency aid giver's information{/translate}</span></td>
    </tr>
    <tr>
        <td style="width: 4.7cm;">{translate}Emergency aid giver{/translate}:</td>
        <td style="border-bottom: 1px dotted #000;">
            {if $deathInfo->get('aid_giver_name') != ''}
            <span>{$deathInfo->get('aid_giver_name')}, </span>
            {/if}
            {if $deathInfo->get('aid_giver_address') != ''}
            <span>{$deathInfo->get('aid_giver_address')}, </span>
            {/if}
            {if $deathInfo->get('aid_giver_phone') != ''}
            <span>{$deathInfo->get('aid_giver_phone')}</span>
            {/if}
        </td>
    </tr>
    <tr>
        <td>&nbsp;</td>
        <td style="border-bottom: 1px dotted #000;">&nbsp;</td>
    </tr>
</table>
<table width="100%">   
    <tr>
        <td style="width: 4cm;">{translate}Patient's property{/translate}:</td>
        <td style="border-bottom: 1px dotted #000;">{$deathInfo->getPatientPossesion()}</td>
    </tr>
    <tr>
        <td>&nbsp;</td>
        <td style="border-bottom: 1px dotted #000;">&nbsp;</td>
    </tr>
</table>  
<table width="100%">  
    <tr>
        <td colspan="2"><span style="font-weight: bold; text-transform: uppercase;">D. {translate}Reception{/translate}</span></td>
    </tr>
    <tr>
        <td style="width: 3.2cm;">{translate}Reception doctor{/translate}:</td>
        <td style="border-bottom: 1px dotted #000;">{$doctorName}</td>
    </tr>
    <tr>
        <td style="width: 3.2cm;">{translate}Reception nurses{/translate}:</td>
        <td style="border-bottom: 1px dotted #000;">{$deathInfo->get('participant_nurse')}</td>
    </tr>
    <tr>
        <td style="width: 3.2cm;">{translate}Internship doctors{/translate}:</td>
        <td style="border-bottom: 1px dotted #000;">{$deathInfo->get('participant_others')}</td>
    </tr>
    <tr>
        <td style="border-bottom: 1px dotted #000;" colspan="2">&nbsp;</td>
    </tr>
</table>
<br/>
<table width="100%">
    <tr>
        <td width="50%" align="left""><span style="text-transform: uppercase;font-weight: bold;">{translate}Emergency aid giver{/translate}<br/></span></td>
        <td width="17%" align="left">
        	<span style="text-transform: uppercase;font-weight: bold;">{translate}Report date{/translate}</span>
       	</td>
       	<td width="33%" style="border-bottom: 1px dotted #000;">&nbsp;</td>
    </tr>
    <tr>
    	<td></td>
    	<td colspan='2' style="text-transform: uppercase;font-weight: bold; text-align: center;">
        	<span>{translate}Doctor{/translate}</span>
        </td>
    </tr>
</table>
</div>
